Bibliographic record
Abstract
Endometriosis is a chronic estrogen-dependent gynecological disease where endometrial cells implant at inappropriate sites causing significant pelvic pain, decreased quality of life, and often infertility. It affects 10% of women of reproductive age, and there is no minimally invasive diagnostic test. Consequently the time to diagnosis, which occurs during laparoscopic surgery followed by pathological confirmation of disease, is prolonged and exceeds 11 years. During this time, the disease often worsens and women thus experience avoidable morbidity. Additionally, endometriosis is a financial burden on the healthcare system; its annual cost was $69.4 billion (U.S.) and $1.8 billion (Canada) in 2009. For these reasons, identifying a clinical marker remains a top priority. Although multiple putative markers have been identified and reviewed, emerging evidence suggests a relationship between neurotrophins and endometriosis. The neurotrophins are growth factors recognized for promoting neuronal differentiation, growth, and maintenance. Recently, they have been shown to induce pathways central to endometriosis including proliferation, adhesion, angiogenesis and resistance to apoptosis, in cultured neurons, epithelial cells, fibroblasts, and cancer cell lines. Although two studies have suggested elevated concentrations of brain-derived neurotrophic factor (BDNF) in the plasma and eutopic endometrium of women with endometriosis, relatively little is known about uterine BDNF. Herein, we demonstrate the conservation of BDNF and its high affinity receptor in the mammalian uterus, and show the upregulation of BDNF and its low affinity receptor by estradiol in the mouse uterus. Encouraged by our results, we assessed circulating BDNF for its ability to differentiate between women with and without endometriosis, as excess estradiol in endometriotic lesions might increase BDNF in women with disease. Our results revealed that circulating BDNF concentrations were significantly higher in women with endometriosis, particularly those with Stage I and II disease compared to controls. Furthermore, women with endometriosis undergoing ovarian suppression had significantly lower circulating BDNF than women not undergoing treatment, suggesting that BDNF may provide an opportunity to monitor patient response to treatment. Taken together, the data herein advances our limited knowledge of uterine neurotrophins, and supports a link between BDNF and endometriosis. I therefore strongly suggest that BDNF is a useful clinical marker of endometriosis, and encourage additional research to determine its role in the pathophysiology of disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".